A stricture and surgery in my future

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farfrmnormal
Regular Member


Date Joined Oct 2009
Total Posts : 117
   Posted 3/9/2010 1:10 PM (GMT -7)   
Hi All

So a little update. September of last year developed a fistula, ultimately formed an abscess that I had surgically drain twice and a seton put in. I started Remicade in January of this year and was back to work February 1st.

I visited my GI yesterday - 2 weeks after my 3rd infusion and I get bombed on! After being told that my small bowel looked good, I now have a stricture that has to be removed! He told me it's not an emergency, but recommends I have it removed while I am healthy. The remicade is doing wonders for my colon and he wants it to be a little more healthy before the surgery. September will probably be the date.

So tell me - is this surgery usually done laproscopically? Should I be watching what I eat more closely? How long was your recovery time after surgery (those of you who have had the surgery)? What all is involved in this?

Thanks!
- Diagnosed Nov 08' but undiagnosed for 13 years prior with no major problems
- First major flare Aug-Sep 09 - I attribute it to intolerance to meds and crappy GI
- Perianal abscess - EUA with drainage and Seton put in
- Meds: Remicade for life


Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3110
   Posted 3/9/2010 5:39 PM (GMT -7)   
where is the stricture?

How the surgery is done depends on the doc and even if they start laparoscopic they may have to do an open...definitely talk with your ColoRectal Surgeon before hand to see what they do.

Have you been bothered by many foods? I thinks you should be careful and if something bothers you...stay away from it.

Usually recovery is 4-6 weeks and you'll be in the hospital about 4-6 days...make sure you walk~A LOT~ after surgery...if it's laparoscopic recover is easier.
Crohn’s dx 1989
some terrible years before my
Proctocolectomy in 2008


farfrmnormal
Regular Member


Date Joined Oct 2009
Total Posts : 117
   Posted 3/10/2010 6:14 AM (GMT -7)   
Hi there! Thanks for your reply. My GI said the stricture is in my small bowel, close to where it connects to the colon.

I used to have problems with certain foods, but since starting Remicade I have fewer problems than before. I usually have to avoid tomato based sauces, green leafy foods and caffeine – but other than that I am pretty good. I just don’t want to be eating foods that could cause a blockage. I have heard to avoid foods with nuts and grains, also to avoid foods with small seeds. I’m really going to miss my fruit if I have to start avoiding it. I usually peel my fruit (fruit that can be peeled of course) as the peel on apples, pears, peaches etc often upset me.

The surgery was just mentioned to me during my last visit – my GI suggested I have it done before it becomes a major problem. I have yet to see the colorectal surgeon – I will have that appointment sometime in June. I’m sure I will learn more about the surgery then.
I was just hoping I could get some insight from those who have already had the procedure.

I’ve also read that some individuals have a problem with diarrhea after a small bowel resection – is this common?
- Diagnosed Nov 08' but undiagnosed for 13 years prior with no major problems
- First major flare Aug-Sep 09 - I attribute it to intolerance to meds and crappy GI
- Perianal abscess - EUA with drainage and Seton put in
- Meds: Remicade for life


Djin
Regular Member


Date Joined Jan 2010
Total Posts : 265
   Posted 3/10/2010 6:35 AM (GMT -7)   
D after ressection is common, but should stop after some weeks, since it's your first. No Short bowel symdrome

Usually, many fruits are ok. Depends on how structured you are. For me banana and papaya was ok. Apples, peaches, etc can be blended.

There are two major ways of thinking.
1. Get your stricture off earlier, before it surprises you.
2. Get your stricture off, only if its bothering you (pain, cramps) --> more common, I did it. (by the way, your stricture is in the same place mine was. It's a common place...)


Good luck!!!
 
-------------------------------------------
Diagnosed in nov/94 - Started with Prednisone, followed by Pentasa, entocort, flagyl, Imuran, Cipro, etc.
Blockage - First Surgery 2001 (no ressection)
Severe bleedind - 2003 - Stopped by 60mg of Prednisone
Stricture leading to a ressection in Dec/2008 - Second Surgery
Now on Remicade + 100 mg Imuran + Iron (sort of remission, not sure at all)
 


farfrmnormal
Regular Member


Date Joined Oct 2009
Total Posts : 117
   Posted 3/10/2010 7:10 AM (GMT -7)   
Again, thank you for your reply.

I have heard that the section I am having removed is quite common. Apparently, Crohn’s likes to hide out in this area.

The reason I am choosing to have the stricture removed is because I do plan on having children in the next year or so. On the advice of my GI he recommended I have the surgery before I get pregnant. He stated that it would be horrible for me to become obstructed and lose the baby. So, surgery it will be. I am also confident that if I have the surgery while I am relatively healthy my recovery will be easier and will probably be much faster. I am fortunate that I do not have any inflammation or active Crohn’s in the small bowel at this time. Hopefully, the Remicade can keep all of that at bay. My doctor has upped my Remicade actually – I am now on 400mg and on a 6 week schedule instead of an 8 week. I think this is this is to insure that the Crohn’s stays in remission. I was also very fortunate that the Remicade put me into remission quite quickly. A week after my first infusion I was eating Chinese without a problem – something like that would have killed me in the past.

It won’t be the same blending the fruit, but I suppose to save myself pain and agony in the future it will all be worth it.

Short bowel syndrome - I have heard of this but do not know exactly what it is. Could you explain?

Any other information others have about this procedure would be great!
- Diagnosed Nov 08' but undiagnosed for 13 years prior with no major problems
- First major flare Aug-Sep 09 - I attribute it to intolerance to meds and crappy GI
- Perianal abscess - EUA with drainage and Seton put in
- Meds: Remicade for life


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 3/10/2010 7:31 AM (GMT -7)   
Short bowel syndrome occurs when you have had multiple resections and have had large amounts of intestine removed.
Gail*Nanners* Co-Moderator for Crohns Disease & Anxiety/Panic
Crohn's Disease for over 34 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

lamb61
Veteran Member


Date Joined Jan 2005
Total Posts : 1719
   Posted 3/10/2010 8:30 AM (GMT -7)   
I agree with being proactive on this. I waited a good year after being told I needed the surgery. It was a year of daily pain & having to watch my diet more than normal.

This was my second resection, first for stricture surgery. It was done in January and started as laproscopic, but ended up open surgery due to scar tissue. I was in hosp. 5 days including the day of surgery. Of course when I came out of surgery, I had the NG tube, cath and 2 IV's. But by day 2 I was up & moving around with minimal pain ( I had a nerve block done). Recovery was slower than I anticipated but I'm 49 yrs old so that could have played a part. It took a few weeks to work back into normal food, but I'm ok now.

Prior to surgery you may have to limit fiber & red meats, these seemed to trigger problems with me. I think it depends on how tight the stricture is -- mine was "the tightest" the surgeon had even seen.

I have had D issues post surg, but controlled with Imodium. The pain is gone -- yippee! And I can eat fresh fruit & veg without pain -- my CD isn't acting up right now.

Good luck!
 


farfrmnormal
Regular Member


Date Joined Oct 2009
Total Posts : 117
   Posted 4/1/2010 12:06 PM (GMT -7)   
How long has it been since your surgery Lamb?
- Diagnosed Nov 08' but undiagnosed for 13 years prior with no major problems
- First major flare Aug-Sep 09 - I attribute it to intolerance to meds and crappy GI
- Perianal abscess - EUA with drainage and Seton put in
- Meds: Remicade for life


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 4/1/2010 12:25 PM (GMT -7)   
I agree with Lamb, red meat is something you should avoid. It is very hard to digest, even for a healthy intestinal tract. I would try to stick with a low residue type diet. Its easy to chew, and easy to digest. You can google the diet to get some ideas. Good luck~
Gail*Nanners* Co-Moderator for Crohns Disease & Anxiety/Panic
Crohn's Disease for over 34 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

farfrmnormal
Regular Member


Date Joined Oct 2009
Total Posts : 117
   Posted 4/1/2010 12:31 PM (GMT -7)   
Oh, I've been avoiding red meat for years now.

I googled the diet and it sounds like I am pretty much following the diet now. I don't eat a lot of high fiber foods - never really did because they bothered me.

I just can't stop eating and I'd rather be eating foods that are good for me. Or things that will curb my appetite.
- Diagnosed Nov 08' but undiagnosed for 13 years prior with no major problems
- First major flare Aug-Sep 09 - I attribute it to intolerance to meds and crappy GI
- Perianal abscess - EUA with drainage and Seton put in
- Meds: Remicade for life


Djin
Regular Member


Date Joined Jan 2010
Total Posts : 265
   Posted 4/1/2010 5:07 PM (GMT -7)   
Hi far!

Congrats for your plans to have a baby. I agree its a good reason to have a surgery beforehand. Making a baby can turn the marriage in a second honeymoon :).

If I were you I would try to be in a cautious diet. Maybe a new flare would postpone your surgery (and your baby). Remi is very good but it's transpassable by the CD if we mess with our gut.
Male, 35 (lovely family of wife and two daughters)
Diagnosed in nov/94 - Started with Prednisone, followed by Pentasa, entocort, flagyl, Imuran, Cipro, etc.
Blockage (popcorn!!) - First Surgery 2001 (no ressection)
Severe bleedind - 2003 - Stopped by 60mg of Prednisone
Stricture leading to a ressection in Dec/2008 - Second Surgery
Now on Remicade + 100 75mg Imuran + Iron (doc said i'm in remission, but I'm not sure at all)
 

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